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Küppers R, Meier S, Batzler YN, Schallenburger M, Wetzchewald D, Dreyer S, Schwartz J, Neukirchen M. [Perspectives of a sample of mostly younger doctors on physician-assisted suicide]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2024; 67:233-241. [PMID: 38253871 PMCID: PMC10834612 DOI: 10.1007/s00103-024-03833-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 12/22/2023] [Indexed: 01/24/2024]
Abstract
BACKGROUND On 26 February 2020, the German Federal Constitutional Court revoked a law (§ 217 StGB) that had banned assisted suicide intended to be repeated on a regularly basis. Since then, a possible new legal regulation has been discussed. This study examined the knowledge, experiences, and attitudes of younger physicians towards physician-assisted suicide (PAS). METHODS A quantitative survey of postgraduate courses in emergency medicine, critical care medicine, and hematology was conducted from November 2022 to March 2023. Possible factors influencing attitudes towards PAS were analyzed. RESULTS A total of 1163 records (response rate 82.1%) were analyzed. Of the participants, 90.8% had experience with dying patients, 62.3% supported PAS only in palliative scenarios, 20.1% supported PAS regardless of the health status, 33.1% have been asked for PAS, and 3.3% had participated in PAS. In addition, 71.0% did not know the content of the Federal Constitutional Court's decision on § 217, 72.0% were not informed about the legislative proposals for the new regulation of PAS, and 66.4% saw doctors as the right person to decide whether a suicidal wish is permissible. CONCLUSION Younger doctors differentiate in their attitude towards PAS between people without illnesses and those in palliative treatment situations. Further investigations into the causes of the frequent ignorance of the normative foundations are necessary. The results suggest that more educational work needs to be done about suicide alternatives and palliative care options.
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Affiliation(s)
- Remo Küppers
- Klinik für Anästhesiologie, Heinrich-Heine-Universität Düsseldorf, Universitätsklinikum Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland
| | - Stefan Meier
- Klinik für Anästhesiologie, Heinrich-Heine-Universität Düsseldorf, Universitätsklinikum Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland.
| | - Yann-Nicolas Batzler
- Interdisziplinäres Zentrum für Palliativmedizin, Heinrich-Heine-Universität Düsseldorf, Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland
- Centrum für Integrierte Onkologie Aachen Bonn Cologne Düsseldorf (CIO ABCD), Düsseldorf, Deutschland
| | - Manuela Schallenburger
- Interdisziplinäres Zentrum für Palliativmedizin, Heinrich-Heine-Universität Düsseldorf, Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland
- Centrum für Integrierte Onkologie Aachen Bonn Cologne Düsseldorf (CIO ABCD), Düsseldorf, Deutschland
| | - Dietmar Wetzchewald
- Institut für Notfallmedizin, Universität Witten/Herdecke, Arnsberg, Deutschland
| | - Sven Dreyer
- Klinik für Orthopädie und Unfallchirurgie, Heinrich-Heine-Universität Düsseldorf, Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland
| | - Jaqueline Schwartz
- Interdisziplinäres Zentrum für Palliativmedizin, Heinrich-Heine-Universität Düsseldorf, Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland
- Centrum für Integrierte Onkologie Aachen Bonn Cologne Düsseldorf (CIO ABCD), Düsseldorf, Deutschland
| | - Martin Neukirchen
- Klinik für Anästhesiologie, Heinrich-Heine-Universität Düsseldorf, Universitätsklinikum Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland
- Interdisziplinäres Zentrum für Palliativmedizin, Heinrich-Heine-Universität Düsseldorf, Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland
- Centrum für Integrierte Onkologie Aachen Bonn Cologne Düsseldorf (CIO ABCD), Düsseldorf, Deutschland
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Jox RJ. Of Slopes and Ropes: Learning from the Diversity of European Regulations of Assisted Dying. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2023; 23:84-87. [PMID: 37879028 DOI: 10.1080/15265161.2023.2256281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2023]
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Tomczyk M, Andorno R, Jox RJ. 'How is it possible that at times we can be physicians and at times assistants in suicide?' Attitudes and experiences of palliative care physicians in respect of the current legal situation of suicide assistance in Switzerland. JOURNAL OF MEDICAL ETHICS 2023; 49:594-601. [PMID: 36609360 DOI: 10.1136/jme-2022-108546] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 11/29/2022] [Indexed: 06/17/2023]
Abstract
INTRODUCTION Switzerland lacks specific legal regulation of assistance in suicide. The practice has, however, developed since the 1980s as a consequence of a gap in the Swiss Criminal Code and is performed by private right-to-die organisations. Traditionally, assistance in suicide is considered contrary to the philosophy of palliative care. Nonetheless, Swiss palliative care physicians regularly receive patient requests for suicide assistance. Their attitudes towards the legal regulations of this practice and their experience in this context remain unclear. OBJECTIVES Our study aimed to explore and describe the attitudes and experiences of Swiss palliative care physicians concerning the legal situation of suicide assistance. METHODS In 2019, we performed an exploratory interview study with 12 Swiss palliative care physicians on palliative sedation as an alternative to assisted suicide. In this paper, we present the results that emerged from a thematic subanalysis of the data. RESULTS Participants stated that assistance in suicide and palliative care are based on opposing philosophies, but they admitted a shift in paradigm over the last years in the sense that one practice does not necessarily exclude the other. They reported various roles in suicide assistance and considered that the current activities of Swiss right-to-die organisations were problematic and needed to be regulated by law. DISCUSSION AND CONCLUSION These results could enrich national and international reflection on suicide assistance in the context of palliative care by reducing confusion between the two practices and strengthening the confidence of patients and their relatives.
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Affiliation(s)
- Martyna Tomczyk
- Institute of Humanities in Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Roberto Andorno
- Institute of Biomedical Ethics and History of Medicine, University of Zurich, Zurich, Switzerland
| | - Ralf J Jox
- Institute of Humanities in Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Palliative and Supportive Care Service, Chair in Geriatric Palliative Care, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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